MAKO robot-assisted total hip arthroplasty: a comprehensive meta-analysis of efficacy and safety outcomes

Abstract

Abstract Background Introduction: Robotic surgery in total hip arthroplasty (THA) has emerged as a promising approach for improving precision and reducing errors. This meta-analysis aimed to compare the efficacy and safety of robot-assisted MAKO total hip arthroplasty. Methods Studies were searched using four databases. Meta-analysis was performed using Review Manager 5.4. Efficacy was assessed radiologically, and functional scores and complications were recorded. Results Twelve studies (1224 hips) were analyzed. The MAKO group achieved greater cup anteversion (MD 1.53, 95%CI 1.04–2.03) and a higher percentage of components within safe inclination and anteversion ranges (p > 0.05). Harris Hip Scores did not differ significantly (MD 0.61, 95%CI -0.22–1.45) but the forgotten joint scores favored MAKO (MD 5.99, 95% CI 4.10–7.88), although not exceeding the minimally clinically significant difference. No differences in intraoperative complications emerged (OR 0.96, 95%CI 0.51–1.79) but preoperative plans significantly mismatched the final cup placement after MAKO (p < 0.05). Conclusions The use of the MAKO robot in THA improves radiological outcomes by enhancing safe prosthesis placement. However, no significant differences were observed in terms of complications. Longer follow-up studies are required to assess the clinical impact of improved radiological results. Level of evidence Level IV metaanalysis of nonrandomized clinical trials. Registration CRD42023433733

Keywords

• MAKO
• Robot-assisted
• Total hip arthroplasty
• THA
• Meta-analysis